Sodium sensitivity of blood pressure in long-term detoxified alcoholics

Abstract

To investigate whether sodium sensitivity of blood pressure participates in the relationship of arterial hypertension to chronic alcohol consumption, 30 alcoholics detoxified from 6 to 12 months and 30 teetotaler controls underwent a dietary sodium manipulation study. They received a daily 55 mmol sodium diet for 7 days, followed by a 260 mmol sodium diet for 7 days. Changes in 24-hour urinary sodium excretion between the end of each period were similar in alcoholics and controls (202±16 SEM mmol and 227±11, respectively). Plasma renin activity in alcoholics was lower than in controls at both low (2.4±0.4 ng angiotensin I/mLXh-1 versus 3.7±0.2, P<0.003) and high sodium intake (0.47±0.10 versus 0.82±0.10, P<0.05), with smaller variations in alcoholics (-1.9±0.3 versus -2.9±0.2, P<0.009). In alcoholics, alteration in sodium intake was followed by greater changes in both systolic and mean blood pressure (ambulatory blood pressure monitoring), which rose by 10.6±2.2 mm Hg and 7.3±1.5 versus 4.7±1.4 and 3.9±1.0 in controls, respectively (P<0.03 for systolic and P<0.05 for mean blood pressure). The ratio of changes in mean blood pressure to those in 24-hour urinary sodium excretion was higher in alcoholics (0.044±0.011 mmHgXmmol-1 versus 0.018±0.0041, P<0.005). Our data show that in detoxified alcoholics, there is an abnormal response of both blood pressure and plasma renin activity to variations in salt intake similar to that in sodium-sensitive arterial hypertension. The precise relationship between the sodium sensitivity of blood pressure in detoxified alcoholics and the long-term influence of alcohol on blood pressure remains to be elucidated.